NPIMap

Organization Active NPI

Innovative Surgical Care, PC

  • Surgery Physician
  • Brockton, MA
National Provider Identifier
1578989232
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
INNOVATIVE SURGICAL CARE, PC
Practice address
1350 Belmont St.
Suite 102
Brockton, MA 02301
Phone
(774) 776-2991
Fax
(774) 776-2996
NPI assigned
Mar 5, 2014
Last updated
Apr 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Valentin Atanassov, MDNPI 1811978794
Title
Owner
Phone
(774) 776-2991

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

1350 Belmont St.
Suite 102
Brockton, MA 02301

Mailing address

1350 Belmont St.
Suite 102
Brockton, MA 02301
Phone (774) 776-2991

National Provider Directory

National Provider Directory

Locations

1350 Belmont St
Ste 102
Brockton, MA 02301
Phone (774) 776-2991

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1393977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619136000000",
    "number": "1578989232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 BELMONT ST.",
            "address_2": "SUITE 102",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "02301",
            "telephone_number": "774-776-2991",
            "fax_number": "774-776-2996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 BELMONT ST.",
            "address_2": "SUITE 102",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "02301",
            "telephone_number": "774-776-2991",
            "fax_number": "774-776-2996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE SURGICAL CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-05",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A",
        "authorized_official_last_name": "ATANASSOV",
        "authorized_official_first_name": "VALENTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "774-776-2991",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.